Maternal and fetal outcome of dengue fever during pregnancy

Divyasree Harikumar Kanakalatha, Sreekumary Radha, Bindu Nambisan


Background: With increasing rate of adult dengue fever victims, the number of infected pregnant women has also increased. Dengue, during pregnancy may be associated with various complications, including maternal mortality, preterm delivery, fetal death, low birth weight, neonatal admissions, fetal anomalies, and miscarriage. Timely intervention can improve the maternal as well as fetal outcome. The aim of the study was to assess the clinical profile, maternal and fetal outcome of dengue fever during pregnancy.

Methods: A prospective study was carried out, among the antenatal patients who were diagnosed with serologically confirmed dengue fever during a period of 18 months; at a Tertiary care Hospital in Government sector in Kerala, South India. Patients were included irrespective of period of gestation of contracting the disease and were followed up till delivery and all babies were followed up to six weeks post-partum.

Results: Thrombocytopenia(<1.5L/mm3) was found in 86.3% patients, of which 2.7% patients had Platelet count below 20,000 cells/mm3 and 4.1% patients required platelet transfusion. Other complications observed were spontaneous abortions (5.5%); preterm birth (9.5%), oligohydramnios (8.2%) and antepartum hemorrhage (4.1%). Fetal distress and meconium stained amniotic fluid were observed in 7.6% and 16.7% patients respectively. Adverse fetal outcome observed were low birth weight (27.3%), prematurity (23%) and 28.7% of the babies required NICU admission.

Conclusions: The gestational age at presentation of dengue fever appeared to be significant. Early onset or late onset in pregnancy appeared to have a bad prognosis. A high index of clinical suspicion is essential in any pregnant female with fever during epidemics especially in endemic areas like Kerala. Conservative medical and obstetrical management is the treatment of choice.


Dengue fever, Dengue haemorrhagic fever, Dengue shock syndrome Thrombocytopenia

Full Text:



Guzman MG, Kouri G. Dengue: an update. Lancet Infect Dis. 2002;2(1):33-42.

Gubler DJ. Dengue, Urbanization and Globalization: The Unholy Trinity of the 21(st) Century. Trop Med Health. 2011;39(Suppl 4):3-11.

Carroll ID, Toovey S, Van Gompel A. Dengue fever and pregnancy - a review and comment. Travel Med Infect Dis. 2007;5:183-8.

Chitra TV, Panicker S. Maternal and fetal outcome of dengue fever in pregnancy. Journal of Vector Borne Diseases. 2011;48(4):210-3.

Kulkarni N. Study on the effectiveness of transfusion programs in dengue patients receiving platelet transfusion. Intern Jour Transf Immunohaemat. 2012;2:11-5.

Tagore S, Yim C F, Kwek K. Dengue haemorrhagic fever complicated by eclampsia in pregnancy. Singapore Med J Case Report. 2007;48(10):e281.

Malhotra N, Chanana C, Kumar S. Dengue infection in pregnancy. Int J Gynaecol Obstet. 2006;94:131-2.

Kariyawasam S, Senanayake H. Dengue infections during pregnancy: case series from a tertiary care hospital in Sri Lanka. J Infect Dev Ctries. 2010;4(11):767-75.

Waduge R, Malavige GN, Pradeepan M, Wijeyaratne CN, Fernando S, Seneviratne SL. Dengue infections during pregnancy: a case series from Sri Lanka and review of the literature. J Clin Virol. 2006;37:27-33.

Carles G, Youssef M. Maternal and foetal consequences of dengue fever during pregnancy. Europ Jour Obstetrics Gynecol Reproduc Biolo. 2009;147:29-32.

Sharma JB, Gulati N: Potential relationship between dengue fever and neural tube defects in a northern district of India. Int J Gynaecol Obstet. 1992;39:291-5.

Agrawal P, Garg R, Srivastava S. Pregnancy Outcome in Women with Dengue Infection in Northern India, Indian Journal of Clinical Practice. 2014;24(11).

Carles G, Peiffer H, Talarmin A. Effects of dengue fever during pregnancy in French Guiana. Clin Infect Dis. 1999;28:637-40.

Carles G, Talarmin A, Peneau C, Bertsch M. Dengue fever and pregnancy. A study of 38 cases in french Guiana. J Gynecol Obstet Biol Reprod. 2000;29:758-62.

Adam I, Jumaa AM, Elbashir HE, Karsany MS. Maternal and perinatal outcomes of dengue in Port Sudan, Eastern Sudan. Virol J. 2010;7:153-7.

Sinhabahu VP, Sathananthan R. Perinatal transmission of dengue: a case report, BMC Research Notes. 2014;7:795.